Healthcare Provider Details

I. General information

NPI: 1770920209
Provider Name (Legal Business Name): ATUL KUMAR MEHTA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2013
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 E RIVER PKWY STE 131
MINNEAPOLIS MN
55455-0368
US

IV. Provider business mailing address

274 UNION BLVD STE 200
LAKEWOOD CO
80228-1835
US

V. Phone/Fax

Practice location:
  • Phone: 612-624-0999
  • Fax:
Mailing address:
  • Phone: 303-951-0600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberDR.0078103
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number72377
License Number StateMN
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number72377
License Number StateMN
# 4
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberDR.0078103
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: